Malapp10ParticipantJanuary 29, 2019 at 9:13 amPost count: 2
Dear Dr. Corenman,
I apologize, I originally posted this under the professional section. Thank you for maintaining this forum. It is nice to have a place to go to read about a difficult diagnosis and have an expert who is willing to comment on it. Two years ago, I was diagnosed with spinal stenosis and a ruptured disk at my C4 through C6 levels. The diagnosis was made with a physical exam and an MRI. I had surgery to correct the problem. The surgery went horribly wrong. I had to have two more surgeries over the next three weeks. I developed a severe infection that required two wash out surgeries. Two more MRI’s were done. In none of the MRI’s was Myelomalacia ever mentioned
During the first surgery, the surgeon attempted to place a catheter and he made a massive mess of it. He scratched my urinary track and prostate gland and ultimately had to have a urologist paged to the operating room to complete the procedure. Soon after the the two washout surgeries I developed a large seroma that covered the top half of my back. After three months of pick lines, massive doses of antibiotics, and other therapies the seroma opened where the scar from the original surgeries was. The opening ultimately became the size of a football before anyone could figure out how to close it. It should be noted that I was now being treated at Jackson Memorial Hospital and with University of Miami doctors. Another surgery was done to attempt to close the opening.
We were now about 4 months into this nightmare and I was going through daily treatments in a bariatric chamber when the doctor who managed the unit of the University of Miami Hospital realized that there was a rather large area of this horribly gross looking mess that was missing skin and allowing more infection into my body. She operated on me doing another skin graph. I was suffering through intense pain throughout the entire ordeal. Another MRI was done and this time they realized that I also had Myelomalacia that started at the level where the first surgery was done and extended into my thoracic spine.
Now a team of doctors from the world famous Miami Projects and the head of Plastic Surgery for the University of Miami who is also world famous for something I’d rather not go into were assembled. This time another fusion was done from the next two levels of my spine down and an enourmous muscle flap was done to cover the mess from the first four surgeries. This time they also removed the original hardware from the first fusion.
This surgery was was incredibly painful and I was now taking massive doses of opioids to control my pain. After a total of ten surgeries, an interthecal pump was installed and I am now up to 9 MG’s per day of morphine that is not controlling my pain, we are changing to dilauded next month.
Finally, we are at my question, it is my understanding that myelomalacia is caused by a traumatic injury of some sort. I had no such injury. There was no diagnosis of myelomalacia until the fifth MRI was done. Is it possible that the surgeon who did the first surgery caused the myelomalacia by improperly utilizing his surgical tools and the foot print of these tools was the cause. Is there any relationship between the infection that was ultimately determined to be Stenotrophomonas maltophilia that likely entered my body through the danged urinary track and the myelomalacia and lastly, is there any hope that my pain level will subside and is there and that the myelomalacia will not ultimately kill me due to respiratory arrest.
Thank you for your timeDonald Corenman, MD, DCModeratorFebruary 4, 2019 at 4:17 pmPost count: 6631
Your plight has been awful and I’m really sorry to hear of your unrelenting pain. Myelomalacia can be caused by cord compression, infection or even problematic surgery. Normally, if there is a cord injury, the initial reaction is swelling of the cord (it turns white on certain MRI scans). Only after the injury is present for some time, will the the cord then atrophy (which is myelomalacia caused by dropout of the nerve tracts in the cord).
What was the first surgery that you underwent and what was the procedure? You can get the original operative report which contains the pre-op diagnosis, the post-op diagnosis and the procedure performed. You can also get this information on every other operation you have had. Just request the records as they are yours and you have a right to them. Copy and paste them here without your identifying information and we can go over them.
Dr. CorenmanPLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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